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High-Risk Target Areas


Oklahoma recommends Universal Blood Lead Screening versus screening based on High Risk Target Areas.

In order to target screening by geographic areas (such as census tracts, counties, or zip codes) in Oklahoma that would be at higher risk for childhood lead poisoning, there must be sufficient data available to demonstrate that certain areas have an increased risk of lead exposure compared to other areas for which the risk of lead exposure is negligible. Risk factors for increased lead exposure could include the prevalence of homes built before 1978, the number of families living below the poverty level, or areas known to have environmental lead exposure, such as mining or smelter communities. In addition to these general risk factors, lead exposure risk can vary among population subgroups due to cultural practices involving the use of items that contain lead, occupational exposures, and recreational activities involving lead. Unfortunately, data quantifying these risk factors are not always available and may not be adequate to assure all children with lead poisoning are identified.

In contrast to screening based on designated High Risk Target Areas, historic blood lead screening rates and the prevalence of elevated blood lead levels can be used to more accurately identify areas of increased lead exposure risk to children. Presently, fewer than 30% of children in Oklahoma, like many other states, have a blood lead screening test at 12 months and 24 months of age.  For this reason, the Oklahoma State Department of Health requires Universal Blood Lead Screening of all children at the age of 12 months and again at 24 months.  In addition, any child, who is not yet 6 years of age and has not had a blood lead screening, is required to receive a blood lead screening. There is no way to know if a child has been exposed to lead without a simple blood test. 

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